News:

With over 100,000 posts and 2 million pageviews, the Voicelessness and Emotional Survival Message Board has become a valuable resource for people learning about and dealing with narcissistic spouses/partners, boyfriends/girlfriends, parents, siblings, adult children, bosses, and co-workers--as well as other sources of "voicelessness."

Author
Topic: The story of "Tiffany" (Read 45468 times)

Mom: “I was just talking to your father, he’s all sad, despondent and ready to move away from here. He says that everything’s so bad with the kids and he’s not helping any. I had a dream last night, about these large worms, and Daddy was trying to kill the worms, that were not deadly, but a nuisance definitely. He was doing it to protect the kids, your sister and her children, mostly. I found myself surrounded by a few worms and I realized I would have to fend for myself. Because he was busy helping the children… I woke up upset and later in the morning, I called him to come to my house and help me with putting on my shoes. [YB] had to wake him up because he was sleeping in. He was obviously sad and depressed, because he never sleeps in. He told me he just couldn’t find any peace in his home. And [YB] trying to choke him left him feeling terrible. He said he thinks he might move to Arizona to live. ‘If the kids wanted to see him, they could come out there and see him.’”

I don’t say anything, but I think to myself that this is not the worst idea I’ve heard.

Mom: “But I think about how life would be if he were to leave. I feel like your Dad really helps to pick up the slack when the children can’t be here for me. But am I supposed to give up my life and my peace?!”

Me: “You think you would lose your peace because Dad would leave and you would have no one to pick up the slack with [YB] and [NSister] and her children.

Mom: “No! I think I would lose my peace if your Dad were to come to live in my house?

Me: “And THAT’s the alternative to his leaving for AZ?

Mom: “Well, he doesn’t really have any money to go anywhere. He’s struggling with the money he’s getting for social security. I figure, how much am I supposed to give up for these kids? And I’m having a hard time dealing with [YB] trying to choke him to death. I’m having a problem with that! [YB] is saying he’s sorry and all that kind of stuff. But how can a child you raise and take care of bring himself to want to hurt you? And did you know, [YB] took the keys and drove up to a town 2 hours drive away from FOO’s hometown, [a town] unannounced to visit the old girlfriend with 11 children. We had to go get him from up there. He fooled his Daddy, said he was going to take his kids to the movies. He ended up in [a town]. Then he called your sister and told her where he was telling her he was dizzy and that the old girlfriend didn’t have very much food with which to take his anti-seizure medication. He just took the car after being bored and laid up with the children for two days. And he had just had a seizure on the previous Tuesday, but nobody told me. So, I decided I was going to get down to [a town] and get him.

Me: “Nobody told you?”

Mom: [YB] had been in a fight with your sister and her oldest daughter about caring for your aunt. Your sister is working as a home aide for Aunt E now, and she was supposed to be getting paid to ‘watch’ Aunt E while [YB] spent time with his children. I guess with all the fighting going on lately, nobody wanted to tell me that [YB] was still having seizures. They didn’t call the ambulance or anything. He was telling his father about the argument with your sister and niece when he went into another seizure. He knocked down the Christmas tree, bent up one of my old walkers. Your Daddy let him lay there and have the seizure and didn’t call the ambulance. I’ve been trying to get myself together because I didn’t want my BP to go through the roof. The next thing I know, [YB] is in [a town]. So when your sister told me where he was, she said, ‘Don’t worry, Mom, I’ll take care of it!’ But she didn’t move fast enough. I had your father to drive me down there because [YB] was like a loaded gun with those babies in that car! I just felt like it’s my fault if anything happened. So I jumped up and asked your Dad to take me down there. He didn’t want to do it. He’s nervous, you see because his son almost choked him. It’s really bothering him how [YB] did him. And it’s bothering me that Dad saw him have a seizure and didn’t help. And when I did find out about the seizure, Dad made it seem like it was my fault because I didn’t put [YB] out of the house when he choked him. I asked him, ‘Why didn’t you call for help?’ Dad said because they were just going to keep him in the Emergency Dept. for a long time, only to send him home without doing anything. So he really didn’t want to drive to [a town] but I made him…But he’s ready to leave [FOO hometown] now, and if I don’t let him move into the house with me, he’s really praying about leaving. The kids are begging him for money all the time, won’t leave him alone, Aunt E is cussing and carrying on and he just can’t get over your brother choking him.

Me: So it sounds like you empathize with both sides of the story.

NMom, (in an increasingly agitated tone): I do, but I don’t want to threaten my own peace. I want a couple of years where I can live in my house and enjoy my home. I really don’t want anybody to come in here and live. But I also know what Dad is going through and he’s in a situation where he can’t afford to go elsewhere. So I guess he could come over here for a few days and pray and not bring more than a change of an outfit.

Jan. 2, 2010- [YB’s] account

Me: Hey brother! What’s all this I hear?

[YB]: It’s been tough for me with Daddy and his refrigerators and his squash and beans and all his stuff. I’ve been frustrated with living in the house with him. Every month I say, ‘Dad, the fridge is nasty. It smells. I clean it over and over and it just gets worse and worse. Once I didn’t clean it just to see how long he would go and fur was growing all over everything. You know he’s always pulling stuff from gardens and he brings them home and don’t clean them. He leaves the vegetables there to rot and mold. And he also has a refrigerator sitting right in the middle of the den. And I’ve been telling him he needs to move the fridge because my kids were coming and I wanted to put the Christmas tree up… We get into a heated debate and then “The Supervisor” showed up. I call [OB] “The Supervisor” because every time he comes around, he’s trying to supervise everyone. I was in my room trying to calm down.

Me: “So, you weren’t engaged with Dad when [OB] showed up?

[YB]: No. Dad and I had finished. I was in my room. I was very upset. I found out that Dad called Mom and she called [OB] to come over to see about the situation. [OB] came after everything was over and was saying, “What are you DOING, [YB] to me, yelling and such. He and I got to scuffling and [OB] got his hand broke. Sister, it’s like this, you fuss with me I tell you to leave me alone. I tell you once. I tell you twice. I tell you three times…Next thing I know I’m grabbing somebody. And they look like they are scared…

Me: “So it’s like blind rage?”

Him: “Yes, it’s like that. It’s like, ‘Can you clean the fridge, Dad?’ Or I’ll tell our niece to stop playing so much with me. Then, the next thing I know I’m yelling at her and she’s jumping out of the car. So I went to a doctor and they are going to give me 6 weeks to have some counseling. The best thing to do is for Dad to move out. And Mom gets mad because I have been disrespectful to Dad. So it’s best for us to separate. Before he moved in, I had fuel assistance for both the summer and winter. When he moved in, he insisted on taking care of the water and electricity bill. So he won’t let us get a clothes-dryer or to turn the lights on because he’s covering those bills. So the regular home aide that comes in washes the clothes and then leaves them outside to dry until someone takes it out of the rain or snow. “

My brother then recalls what life was like inside the house we were teenagers in. He complained of newspapers being everywhere and food, tvs and furniture being locked up in closets. “ Now he’s stockpiling expensive furniture and fixtures outside in the elements. I don’t know where he gets the stuff. But he gets a lot of stuff and there’s all this stuff out in the yard and there’s trash spread among it. He covers things with tarp held down with cinder blocks. Well, you know how Dad is…But when I say something about being tired of living like this…The only way things are going to change is if Mom comes in and specifies which of these things have to go. And I know I wouldn’t be living like this if I lived by myself. So I got my own fridge, to put in my room because when I clean the fridge in the kitchen, in 7 days it’s completely nasty again. And I am thinking about getting one of those small electric stoves to go in my room. I’ve already got the big TV y’all gave me last year, a stereo, and my CPAP machine. With my $150 in food stamps and my disability check, I get a little money to get myself a t-shirt, and my toiletries.

Me: So you had a seizure recently

[YB]: I was playing on the piano a couple of days after the incident between Dad and me happened. I felt the seizure coming on and I tried to walk fast to the living room to be with Daddy and out of the sight of the kids. I didn’t make it. I fell. I woke up in the living room. It was a mild seizure. I think it came on because they recently changed my meds, plus, I’ve been very frustrated, and a little overwhelmed. They (Daddy) took the keys away because I had the seizure the week before. But I made Dad give me the kids Monday, because the kids and me wanted to see [mother of 11 who now lives in ‘a town’] for Christmas. When I went to her house, last Monday with the kids for a couple of days, I started to get a little dizzy. I stayed an extra day because I wasn’t feeling good enough to drive back home. Mom insisted on coming to get me after day three and she took the kids back home.

Me: What do you think should happen?

[YB]: Dad should move out and take his trash and fill it up somewhere else. And let Aunt E. stay and let her get old or whatever. I can live with her now, with the aides coming in to help her everyday. I was doing just fine until I let [mother of 11] move in with all of her children. I let them move in for a while, but they had to get out of the house, because of Mom putting a for lease sign in front of my house, trying to make her sign a rental agreement, and because of the incident with her daughter cutting me in the arm with a knife. Once they left, I had a seizure and when I came back home after the seizure, Dad was living here. And I know how he lived before, in filth. But I know how I want to live. It seems like the more I clean up, the more mess he leaves. Its like chaos.”

Me: So, you’re going to talk to a therapist?

[YB]: Yes, I have a prescription for 6 weeks of counseling.

Me: What do you think you’ll talk about?

[YB]: Lack of quality time with father growing up. It affected me that I had so little quality family face time. Dad was in church every day of the week and after a day at work, he would come home and sleep all day. I really lost control with Dad, I remember the look he had in his face, like a helpless child. Sometimes I catch myself and I think of my children.

Jan 5, 2010-Dad’s account

Dad: “Your Mom and I had had a spiritual day at church this Sunday past, her first time back in a really long time. Service was beautiful. We ate at Golden China. And we had gone to Staples to get some supplies because she wants to get the new year started off with work tomorrow. Just the day before [YB] had apologized and committed to attending therapy. But then Aunt E had a really bad day. One of those days where she keeps saying, “I wanna die! And she hits herself and cries. When I get home, your sister, who was there to watch Aunt E, started screaming at me. ‘Whose going to take [niece] to school tomorrow? She’s so used to depending on me. She’s got a car, and she’s working. But I have to be up at 6:40 in the morning bringing [niece] down near where your mother lives to catch the bus. But this is a new yeae and I’m not going to be…And your brother, he wanted so badly to go to [a town] to see that girl with all the kids. Do you know he had the nerve to ask [OB] for some money after what he did to his hand? [YB] was demanding the car keys from me again. With all that noise coming from every direction, I just grabbed my grip and came back to your mother’s house.”

Me: Sounds like a lot of stress…

Dad: “And all [YB] wants to do is to get together with [mother of 11]. He told me that he wanted to take his children to a movie or something and the next thing you know he was off in [a town]. [Mother of 11] was not expecting him. It was the end of the month and she had hardly enough money and groceries to feed her own kids. [YB] had a little money because your mother gave him money to buy his children Christmas presents. When we went down there to get them, all he wanted to do was stay and let us take his kids back. The round trip to where the children live from your brother’s house is 130 miles. And it’s mostly me going to get them.”

Me: Do you have a problem with [YB] getting together with [mother of 11]?

Dad: No, I don’t have a problem. He can chose to be with whomever he wants to be with. (After a pause…) Well, I DO have a problem with her because she’s got all those kids and because one of her children almost sliced your brother with a butcher knife!

Me: Sounds like a lot of violence going on there…

Dad: Well, in one of your brother’s blind rages, he made it so that he can no longer get into his children’s mother’s gated housing community And me too because we have the same name. That night he had snuck off with the car and ran out of gas and I had to go and get him anyway. When he took his kids down there to [a town], he threatened the kids not to tell their mom. If these people find out that D’s been having all these seizures, we might be liable.

Me: Would it be okay for [YB] to go see her if he didn’t drive?

Dad: Yeah, but [YB] can’t keep his own kids. After 3 days, he’s debilitated, he’s wore out. And there have been times when he goes to get his kids then he gets someone to keep his kids. And he’s having falling out seizures. He’s free to go. He’s is own person. And I don’t want to see him in Central State [Mental Hospital]. He’s on a breathing apparatus. And he forgets to take his medication. [YB] will sit in the car, with the trees going by and it will trigger a seizure. How is he going to fare? He’s getting worse!

He’s going to have to deal with [mother of 11] and her kids and with his children’s mother and their kids. And he snaps in a minute and he’s ready to fight. I recently attempted to help cash a check for [family friend] from the pastor of the [YB’s} church who paid the family friend for cutting the grass. [YB] got mad because some time went by before the check was cashed and [YB] went down to his house, snatched up [family friend] and demanded that he take care of the issue promptly. [YB] was trying to protect his reputation with his pastor. [Family friend], your sister, and I had already discussed how we were going to settle it. [YB] snatched [family friend] and dragged him into the street and down to our house. [Family friend] stormed out and called the cops and your mother. She agreed to hire [family friend] to do $30 worth of housework. [YB] has a short fuse. When I walked into the house after church Sunday, [YB] and your sister were both at a heightened level of rage and they both were acting exactly the same. And your Mom’s talking about a change that has to happen this year.

The current state of affairs with my Nmom’s retirement and finances are that the business tax liabilities accumulated over the years now total about $650,000. She is past due in the amount of $12,000 in her business back-taxes and $22,000 in personal property taxes on the homes occupied by her adult children, my siblings. Her current monthly business bills include a recently re-arranged consolidated federal tax payment ($3,000/month), state unemployment taxes ($1,031/month) and a ($3,000/month) payment arrangement for penalty repayments of government monies sanctioned from a previous government agency-directed audit. Bi-weekly payroll accounts for 75% of the monthly income billed for the work of the nurse aides who work in the community. In a nutshell, she does not have the income to support her monthly payroll and tax obligations. That is to say nothing of her personal expenses, e.g., prescriptions, car costs, and costs of living.

I point out to her the ‘writing on the wall’: that government-sponsored home care is experiencing federal cutbacks (in anticipation of the Baby Boomers moving into the 80+ years demographic, making them the largest age-segment of the US population, threatening to break apart Medicare, Medicaid, and Social Security) and are simultaneously cutting home nursing care and other healthcare services driving home healthcare consumers to find their own in-home help and reduce the benefits of those who require more extensive, skilled care.

When faced with the prospect of giving up the business she’d built over 25 years, Nmom’s take: “If I didn’t give the business a final chance, I may give up on the last thing I have to fix this IRS problem! They might forgive the federal/business IRS stuff, but what about the personal stuff that’s in my name!?! With that and my 8 recent hospitalizations…” Her voice fades into incoherent mumbling.

With a change of tone, she directs towards me, “I needed you to visit some of my clients, but I managed and made it out there yesterday…”

In lieu of her frightening financial status and her strong desire to keep the business going, I have now found it nearly impossible to continue to deny her requests for me to help her. She wants me to provide monthly nursing assessments for her clients and employee in-service training for her home health aides. Reluctantly, I agreed to give her one day per week to make nursing visits to 20 clients and in-home training to 25 nurse’s aides. NMother has promised that I will be able to have some flexibility in making these visits as my full time graduate school schedule will allow.

During our talks about the viability of the business and the possibilities for improving the profit margin, I’ve often suggested that she consider increasing training opportunities for nurse’s aides by re-establishing her nurse’s aide education program. She, completely uninterested in the idea, told me that I was free to do whatever I wanted to do with what remained of her training program, which hadn’t offered a course in over 2 years.

I later approached the state agency that provides accreditation for these programs and she informed me that my Nmother’s school had actually been defunct for the last several years, as the agency was unable to reach my mother by telephone or mail regarding her school’s status. If I wanted to start a new nurse’s aide training program I was free to do so, according to the accrediting agency, however, my Nmother’s program was no more. But before I could tell NMom of this discovery, she called me with a concern. Her concern was about me remembering to “cut her in” on any forthcoming business ventures resulting from or related to her companies.

NMom: “I’m just so tired of people always taking from me and not giving back. Your sister thinks you ‘messed up’ things with the business before and your brother is concerned you won’t show up for me and give us what I need. They believe that you will take from the nurse’s training program and won’t give back.”

Without explaining to her that not only would I love nothing more than to remain completely disconnected with any of her business affairs, especially since there is nothing much left to connect to, but that I have every reason to be bitter and angry about the evil, destructive role my Nmother played in making sure I went out of business 5 years ago. I was at first, very bitter, however, at this point in my life/career, while the scar of the experience remains, the pain has subsided and I attempt to maintain an awareness that it could happen again. Forgiving her for that offense was made easier because losing the business eventually led me to where I am now. I do find it quite rich, however, that she is worried that I may possibly have some success with her now defunct nurse aide training program and is now putting in a word of concern on behalf of my siblings and herself. Very rich. I don’t bother to reveal what I learned about the defunct school to my mother when we talk. My gut tells me it may end up being better to be discreet about her former school particularly, as she cockily demands “a cut” of my future profits. Nonetheless in my sheer worry about her impending financial doom, I suggest she develop a written proposal to present to the IRS representative detailing why he should negotiate a plan with her in return for letting her keep her business doors open and try to turn this financial downward spiral around. Fast forward a few days, the proposal is successful; Nmom gets to keep doing business if she pays them $3000 in backtaxes and $1500/month…

The MEMORIAL DAY FALL

On Memorial Day, I called my mother’s home to check on her and [Older Brother-OB] picked up the line. He told me our mother’s home calls had been transferred to her cell phone, which he was answering because she had been admitted to the hospital. Two days ago, in the morning preparing to go to church NMom fell in the bathroom. She fell on her face. Her words to me on what happened:

“Your Dad’s been pressuring me to go to church. And with all the stuff I’m thinking about and going through with the taxes and business and all… It was my desire to go to church especially because your Dad has been making me feel so guilty about not making it to church on Sundays, so I was in the bathroom getting ready to step into the shower when, I don’t know what happened, I just fell, there was no water on the floor, I didn’t black out. I just fell…”

[OB] who was seated in the hospital room with an open textbook when I arrived at the hospital quickly dispersed upon my arrival. His youngest son and namesake was in town to visit him when Nmother fell and their time was interrupted as my brother ended up initially answering her distress call and subsequently sitting vigil at her bedside as the blood gushed from a broken artery in her nose for 24 hours. Once the initial hospital to which she was taken transferred her to another regional hospital they were able to stabilize the bleeding, but they kept her overnight for observation on the cardiac floor because of her medical history. Once I found out what happened (yes, no one called me to let me know for 48 hours), I went to visit her. As I arrived, my oldest brother rushed quietly and purposively from the hospital room as my husband, daughters and I began exchanging awkward words with Mom. She seemed extremely pitiful in her blood stained hospital gown, and gauze packed left nostril. Her voice was much weaker than normal and while straining to hear her speak is commonplace, it was particularly creepy having to put my face so close to hers to hear her words.

Her affect changed precipitously throughout the visit ranging from extreme pitiful-ness when I arrived to upbeat cheerfulness when everyone left and it was just her and me in the small shared hospital room. Nmother, who admitted to having had a “rough night” the evening before gave notice to the nightshift nurses that her daughter had her PhD in nursing…

“Mom, I wish you wouldn’t do that!”

“Do what?!

“Tell people that I have my degree when I haven’t completed it yet. It’s probably bad luck or something.” I don’t point out to her that it is also a blatant lie.

“Not true, there’s still a long road ahead through this dissertation. Do you know how many people are walking around here ABD? (all but dissertation). There’s a lot. Like 50% of those who enter PhD programs. Graduation is not a given.”

“Well, they know you are a nurse and they probably have talked about it to each other.”

“Well, when they come in today is there something you want me to talk to them about, your pain control?”

NMom: “I just want them to meet you. You can talk to them about whatever you want. You know your father sat up all night holding ice to my swollen forehead. I thought I had broken the bones in my face.”

When she fell, my Dad was upstairs in her home. He’s been staying upstairs recently because she wanted someone in her home to keep her company and to aide her in her activities of daily living. Activities like dressing, transporting from place to place (she is a morbidly obese woman who uses a power scooter to move about) and fetching things for her and her children like cash from the ATM, fast food, or what have you. Dad denied hearing her when she was screaming and calling out after the fall. So she slithered in a low-crawl on her side using her elbows to drag herself across the floor, bright red blood gushing from her face. She said she heard an audible crack when she fell and watched her blood pulsing in time with her rapid heartbeat as she cried out to my father. After sliding over to her bedside stand from her bathroom, she used the house phone to call my father on another house phone, which he also did not answer.

What could he have been doing? The cavernous ceilings in Nmom’s home create such an echo throughout the house, it would be difficult not to hear a scream, much less, a whimper. A clandestine walk upstairs in my father’s space (ordered of me by my suspicious Nmother) earlier that week when he was out running errands only revealed a junky, cluttered couple of rooms and a mysteriously locked door with the door handle torn, ripped, cut off, which, I couldn’t tell). As I crouched down to peer at what was left of the sawed-off door handle, the hairs on the back of my neck stood up. I chuckled at a sinister thought that quickly ran through my mind and called out loudly to my mother, “Just a lot of Dad’s stuff and locked door!” She, who was sitting in her scooter chair in the great room waiting for me to return downstairs, called back, “Well, I know I hear him making a lot of noise up there at night, and he’s always acting like he can’t hear me when I call. What good is it having him around if he can’t hear me when I call.”

On the day of the fall, Nmom called [OB’s] telephone next. He rushed over, called an ambulance, went upstairs and found Dad, and took on the responsibilities of the first responder. Nmom smiled as she described how intensely rude Dad was to the EMTs barking orders at them to be quick and careful when moving her. He was in an almost-panic fervor once he saw the degree of her injuries with all the blood on the white tiled bathroom floor. She seemed to appreciate his level of concern despite her earlier misgivings.

My mind flashed to what must have been a similar scene two years ago when one of my Dad’s twin infant granddaughters fell face-forward out of her infant carrier/carseat and suffered a brain injury while in his care. My sister similarly described how intensely rude he was with the hospital staff, and how that somehow signified his remorse for his inattention. I can recall several similar instances throughout my family’s history, (e.g., a set of brakes that went out on me when I was teenager and a blown out tire that went out on my younger brother [YB], both of which instances happened immediately after my father performed maintenance to our albeit, clunkers).

I also think of other trips my Dad has made with his family to the ER with [YB] and his seizures, with the elderly, Alzheimer’s-stricken Aunt E., when she fell on the sidewalk in front of the house and when [OB’s] arm was broken in two places recently when an enraged [YB] assaulted him. I shudder to think of how well the personnel at the local Emergency Department know our injury prone family.

I try to push out of my mind thoughts of foul play. But I can’t help but wonder: Could these accidents, these slippages be my Nmother’s way of garnering attention, rallying the troops to her as her business comes in for its final descent. I think back to a hospitalization last year this time. A hypertensive crisis that immediately followed a tax lien being placed on the home in which she lives and the subsequent anxiety and stress that caused. I ask myself how likely is it that her fall was not a complete accident before feeling shame for being so suspicious. Besides, it’s a little out of character for her to intentionally bring harm to herself. Munchausen-by-proxy is more her type of manipulation. So, while I don’t have all the details my feelers are up…

During an early morning visit to NMom’s, Dad comes into her bedroom with a bowl of thin, watery oatmeal accompanied by a boiled egg. After placing the breakfast on a side table, Dad asks me about my one-year old daughter, his granddaughter. He is quickly shooed away by Nmother who is multi-tasking: tasting food, talking to me, and shuffling work-related papers and forms from desk to crate. She tries the oatmeal, frowns, slams the bowl down onto the saucer and yells to Dad that the texture of the oatmeal is not right. “It’s too soupy!” He returns, she yells, he walks away leaving me standing there alone with her. As if looking at me standing there alone jars her out of her narcissistic rant, she stops and gingerly touches her nose grimacing. Like a wounded animal she skulks and licks her own wounds. I stand still and find myself trying to disappear.

Dad returns shortly with another bowl of oatmeal, this time it is semi-solid in consistency. He cheerfully puts the bowl before her.

“That better?” He says smiling.

Mom, with furrowed brow and agitated disposition, says “Forget it, I just won’t eat. You just can’t get this right! I like my oatmeal soupy but without so much milk!”

Dad says, “Okay, well that’s what I tried to do. If you don’t want it what can I do?”

He then turns to me and says, “I like that dress you’re wearing. It’s not like the flimsy stuff you see girls wearing these days.”

A bit uncomfortable at the sudden shift in attention, I say, “What this dress? I got it when I went on a trip recently…” NMom, rubbing her sore nose and face, frowns again and begins to whimper. Daddy skulks away. As I stand there quietly, she begins to complain about how she’s feeling. She talks about how she’s been feeling “invisible” lately, like no one is really listening to her, about how she cannot get anyone to come and regularly stay with her and bring her food and help her with her medications or take her blood sugar or blood pressure when she feels out of sorts. I hear this 20-minute monologue but find that I, like the rest of the family am not “really listening.” There is a tone in her speaking voice that actually makes me want to run away or disappear. My composed veneer is hiding a true desire to scream in frustration and leave. And to be honest, at this time, I am not really sure why I feel this way, but in the months that follow, I will come to identify my frustration and I will leave. But for now, I am here. I am trying to help my mother in her time of crisis. I am trying to be supportive of her healthcare needs and her business needs. I am now doing what I once thought I would never do again, I’m making an attempt to work with my NMom in her business. I’ve agreed to do a few nursing visits.

While visiting NMom’s clientele and getting a feel for how the business is run, I have a conversation with an office worker, [Pamela]. My brother, [OB] has dispatched [Pamela] to my aid in navigating the confusing highway routes to complete an initial home visit for a new client. She is driving me, in my NMother’s work vehicle over rural roads familiar to her, but foreign to me. The new clients are a result of [OB’s] renewed marketing efforts and his strong desire to help prevent the business from going under. He has a lot of interest vested in the business’ doing well; he is approaching 50 years of age, and has to make up for his many wasted years of being a hard-core alcohol, cocaine, and heroin addict. His Bi-polar disorder is being held in check by his medications and he is going to 12-step meetings religiously.

Because the finances were so bad off, [OB] and I, the two individuals most familiar with the daily goings on of the business, are doing everything we know to do to support NMom, neither of us taking a paycheck for the work. [OB] is making money in the form of rental income from two buildings my NMother lease but allow him to live in and sublease. My brother, an entrepreneurial type, is now trying to parlay Nmother’s unfulfilled possibilities into opportunities for himself. Secretly, I wish him luck with that…

On the ride to visit the clients, the office worker explains, in so many words, how stressful it is working with/for [OB], how he often has her to perform certain work-related tasks (e.g., enforcing the late policy, correcting timesheet errors, etc.) that are later counteracted or reversed as a result of the field employees circumventing her and complaining to my mother. As I glimpse at her countenance from the passenger seat, I detect that familiar nebulous aura of frustration, which, in this case, is misdirected towards [OB]. In her eyes, the crap rolls downhill and her most immediate higher-up is my brother; Nmother is not on her radar as the likely source of her frustration. As we meander through the serene countryside, the office worker, an energetic young single-mother chats about how she once had goals of becoming a registered nurse, but now, after talking with my mother, she thinks it is a bad idea.

“Really?” I ask her. “Why?”

“Because, your mother talks about how difficult the schooling is and how hard the work is and she is always complaining about her business and the aides who work for her. So I figure I should just keep working with her as an office worker and maybe get my nurse aide license instead.”

I resist the urge to say anything about how sharp, articulate, and capable of being a registered nurse I think she is and how my Nmother can be a real dream-killer at times; instead, I comment on how beautiful I think the dairy farms are. Too often I’ve made the mistake of contradicting my mother in this way and paid the price. No good deed goes unpunished, and the like. Preparing for the task before me, I ask the office worker about the new clients we are about to see.

“I notice the two clients we are seeing today have family members working as their home health aides. Are there many like this?”

With a slight look of worry, she responds, “Yes, maybe 10 or so.”

“So about half of the clientele?”

“Maybe a little more than half…”

Within my Nmother’s agency, there are home aides who are being paid to care for their own mothers. Some have the same addresses file. [Pamela] also tells me about an aide who used [Pamela’s] name to complete employment applications at other jobs so that she could make additional income on her mother’s care, essentially committing Medicaid fraud.

I think of my Nmother and Aunt E and I think the employee apples don’t fall far from their boss’s tree.

Later that month, I called [OB] to wish him a Happy Father’s Day. When I asked him if he was doing something special to celebrate it, he says, “No, the work here never stops. We have six new clients in the last 2 weeks. We really need a nurse to do some ‘backup’ nursing now that Mom has had a fall.”

Even on his day off, [OB] can only worry about our mother’s business. He has three sons by three different women, with none of whom he raised his children. And because [OB] had no relationship with his own biological father (a much older man Nmother met and lived with when she was just out of high school), [OB] had no real interest in commemorating Father’s Day. I’m thinking of this and how proud I am of my brother’s sobriety when I respond with, “Well call me, I’ll help.”

I ask him about his sobriety and he reveals a recent almost-relapse following a series of devastating events with the family that had him telling himself, ‘Well, let’s just take all these problems and situations and sprinkle some crack on top of it!’ He remembered the date, it was Friday, April 22nd. He had just found out from a female cousin that our sister told her about his girlfriend’s positive HIV status. My brother was infuriated because he intentionally did not tell my sister about his girlfriend as she was a known gossiper to the people of our family’s small town. [OB] said he told only two people about his girlfriend’s health status and his decision to stay with her despite it. Our mother and me. He called me to ask about the scientific possibility of him having infected her with HIV, while remaining HIV negative himself. He’d admitted to being unfaithful at a point during their relationship. I told him that wasn’t exactly the way it worked. I told him if he was HIV negative and she had contracted HIV during their three-year relationship it was likely a result of her own infidelity, not his. Despite the suspicions and later confirmations of his girlfriend’s trysts with a former lover, known by others to be HIV positive, [OB] decided to stay with her. [OB] said jer HIV counts were undetectable and they were having protected sex. Somehow, he told me, his sobriety was closely linked with this woman, who despite advice to do otherwise, attends the same Narcotics Anonymous meetings as [OB], and despite her seductive and manipulative ways, the likes of which [OB] has admitted to finding intriguing, he cannot leave this woman.

Enraged upon hearing that his business had been spread among his community, his first inclination was to scold Nmother. He told me he removed the business keys from his keychain and handed them over to her, quitting the business because he could not believe she would tell our sister, who was known to spread hurtful gossip, no matter who it hurt. When he went home that day, he seriously contemplated relapsing. “But I just turned out the lights and went to sleep that day.”

“Wow, [OB]! Are you going to be okay?”

“Yeah, I’m okay, and I’ve since come back to the business. But, I have to go now since I’m studying for an abnormal psych test.”

“Are you learning anything about our family in that class?” I joke.

“Yeah, I learned our sister is a sociopath!” exclaims [OB] with a laugh. I don’t laugh, though, because this is something I’ve known for a while now. And I don’t mention that additionally, I think our Mom is a narcissist, our Dad, her co-dependent, abusive soulmate; our brother, a depressed victim of our Nmom’s Maunchausen by Proxy; our niece, a sociopath-in-training; and me an avoidant, overly anxious, overachiever. [OB], diagnosed with and currently taking meds to manage his Bipolar disorder and at one point, given the psychiatric crimes moniker, “Severely Mentally Disturbed,” knows he comes from a family with a host of mental health issues.

[OB], however, feels the huge elephant in the room is our sister. He complains that while he currently gets no paycheck, our sister receives, (or commandeers, rather) two paychecks per month, and additionally asks for cash advances on those checks and daily borrows $20 dollars from anyone she can find. She also steals Nmother’s ATM card and draws cash from that when she hasn’t driven those accounts into negative balances. And, either by example or by direction, she has trained her oldest daughter, 13, to do the same.

[OB’s] frustration is about to spill over the top when he mentions that he now has to figure out how to make more money in the business, because in order for him to finish school and make an independent lifestyle for himself, he would need to pay out the terms of the new agreement he just made in his own name on my mother’s rental property taxes. I think about what my [OB] says and I tally the toll. He’s not getting paid a paycheck, his growth in the business is limited by Nmother’s micromanaging and undermining, and he is personally, now ‘on the hook’ for thousands of dollars in property taxes on Nmother’s buildings. I would say the real ‘elephant in the room’ is not my sister, it is our mother. And she is not an elephant, she is something far more devastating and cruel.

A recent telephone conversation with [YB] initially reveals his desires to settle down and be married and his attraction to a tall beautiful woman at the church where he plays the piano. He also reveals his frustrations with the family. After his recent week-long trip to the mental health unit at the local hospital, [YB] was feeling trapped by his epilepsy (of nonspecific origin) not having a stable means of income, not having a vehicle, and having to live in his Nmother’s rental along with his [Nsis], her three young children and his 89 year-old Alzheimer’s-riddled great-aunt. He began seeing a mental health therapist, but stopped when the therapist changed the dosage on his anti-seizure medicine prescription.

Me: “Why would he do that?”

[YB]: “I don’t know”

Me: “Did he put you on new medication as well”

[YB]: “Yes, something to help me with my anger management”

Me: “So what happened?”

[YB]: “I started having the seizures again. When I went back to the doctor who first prescribed the seizure medicine, he told me not to ever let a doctor change the dose of my medicines and so I haven’t been back to the therapist.”

Me: “What is it like when you get angry?”

[YB]: “It’s like I’m okay and then something flips my lid and I turn into “The Hulk” That’s what I feel like, “The Hulk” you know the way he does. And when it’s over I have to apologize to people. And it’s not me. I can’t make it 6 months without a seizure. This time I only have a month to go. Not too long ago, I felt a big one coming on, so I called the ambulance and they gave me medicine through the needle in my arm and I didn’t have the seizure.”

Me: “Do you have a plan for getting yourself together?”

[YB]: “I plan to get help from the Department of Social Services & Social Security to be able to survive on my own in this house. Maybe get a side job playing the keyboard at churches for money. Mom doesn’t think it’s right for Great Aunt E to go into a nursing home, so I guess she will stay around.”

[YB]: “Yeah, I think I heard that somewhere, too. But I don’t believe she wants that. She really wants to see E taken care of by family. Recently, [Nsis] and [her 13 year old daughter-niece] and myself got into altercation over being in house with Aunt E. The way they live really rubs me the wrong way. The way they talk to people and argue loudly with each other really gets to me. I’m trying to change and upgrade and they are always pulling me down. It’s a struggle, a setback. And [Nsis] takes up for [niece] even when she’s caught in the act of doing something wrong. I caught her stealing $75 from my wallet! I have no desire to stay I this situation. I can’t just jump off without a platform. Sometimes when [NMom] is stressed, she lashes out at me and I have to take that. So I have to help keep her stress low. Meanwhile, no one trusts me to do anything and everyone expects me to be sick. They let me drive [NMom] around town, but not myself. That’s frustrating. It would be nice to have someone on my side. A cheerleader to help get me to be where I want to be. I’m not asking for much, right?”

Me: “You sound like you need to get out of your rut. Doesn’t the Scripture say your gifts will make way for you? You should use your musical gifts to make money. And have some faith in yourself. I seem to remember when we were teenagers in high school my girlfriends would sometimes tell me you were cute and ask if you had a girlfriend. Of course, I told them “Ask him yourself.” But you know you never seemed to have problems attracting women. There’s a woman out there who would make a good partner for you.”

[YB]: “I love talking to you. I always feel so uplifted. It’s like I get a “charge” or “charged up” like a battery. You give me things to think about.”

The next day I check in with NMom who is taking care of work-related business from her home office with [OB’s] help. At this time, she is fixated on NSis, who is experiencing some mental and physical health issues.

[NMom]: “Your sister was here yesterday to borrow some money. And her kids were out in the car. I felt like she was hiding something from me and told her to bring in the kids so that I could see them. [Niece] had hives all over her body and nobody was sure what caused them. She didn’t know whether to go to the ER or to schedule’ a doctor’s appointment. The twins’ hair was extremely matted and they both had a thick, severe case of dandruff that required a special $35 prescription bottle of shampoo to treat it. On top of that, your sister has been calling me telling me she has chest pain and wants to go to the emergency room one minute, then says it’s just gas pain the next minute. This is an opportunity to have a mental health professional see her, Your brother’s doctor could see her about her anxiety. She doesn’t have health insurance. So we will have to cover it. We can take care of the babies and take her to the doctor and spend some time tending to her. I had a disturbing vision of seeing your sister whispering to someone that she wanted to kill herself. I want to help her. Give her a break. And I thought I would help her. If we can take her kids while she goes down to see her friends or something like that. I would like to find out how to help. It’s time for us to do something on the medical side.”

I can hear [OB] in the background muttering something to [NMom] about a conversation he has going on another phone line: “They say they are still missing one of the three payments…”

After an awkward silence NMom reveals to me that she is going to pick up [NSis] and together, they will be making the nursing visits [OB] had previously arranged for me to make. He and I had spoken earlier about ways I could help our mother and the business as she recuperated from her fall a couple of months earlier. I agreed to be on-call for a few home visits, if needed.

Me: “So I won’t be needed tomorrow?”

Her: “Well, I’m anxious for you to do your school stuff.”

Me: “Well, I guess I need to call brother to tell him I won’t be there tomorrow”

Her: “No need. He’s in the next room. I’ll tell him.”

Me: “I’m here to help. I came in because things seemed really bad with the tax creditors and all…”

Her: “Well, let me work on that. Let me work that out with [OB] Were going to take care of it. It’s something I need to think more about.”

Me: “OK”

Two days later; it’s a Friday morning. I spoke to brother on Wednesday asking him if he still needed my help. After speaking to NMom, she told me she would take care of the initial home visits of 2 new clients. She had been complaining about being in hypertensive crisis earlier, and about [Nsis’s] most recent issues with anxiety/depression, so I figured she probably never made the visits.

She lets me know that she’s in a good mood today, whatever that means. She says she is feeling “charged” after running into a city council member who remembered her from the community development center (CDC) I began immediately following graduation from my Bachelor’s program 15 years ago. I began the CDC as a project, something to do after not getting in medical school, something to fill my days with while I applied to and awaited starting my Master’s program. [NMom], who was at the pinnacle of her wealth at that time and thrilled with the idea that I would not be going across the country somewhere for medical school and staying close to home/her, agreed to help me acquire a rental space and paid me a $10/hour salary to do whatever I had the inclination to do. I could have done like my brother and worked in administration of the home care agency, but I decided to start a non profit, grassroots agency with a soup kitchen, clothes closet, and welfare-to-work job training program. It was an overnight success, featured in the local newspaper as an energizing new thing to be happening in the small industrial town. The notoriety piqued my mother’s interest, although she had never come in to check on how the non-profit organization was doing prior to the publication of the news article. [NMom] naturally took all the attention and ran with it, turning her attention towards the non-profit CDC, completely taking over my efforts and ideas with her own self-driven ideas about the directions in which the organization should go. She eventually made the recipients of the CDC services her target church and formed a congregation with the grateful community citizens. Not exactly my idea about how non-profits should be run, but I lost creative control over this CDC relatively quickly once people began to pay attention. This female council member whom [Nmom] saw earlier thought for sure, [NMom] was going to eventually run for council and unseat the old incumbent who was still serving as councilman and often described as quite senile. NMom was flattered by this. This bit of N supply “charged” her and you could hear it in her voice.

The specific word “charged” was used by my brother and I two days before. So, I figured she must have talked to him, particularly after she said, “Well, Tiffany, I know my gifts will make way for me…” the scripture I referred [YB] to when trying to encourage him to hang in there. Minutes later, she mentions taking the family out to dinner the evening before. Family being: [YB], [Nsis], her three daughters, and Dad. She said they had a “good time.” I never seem to be invited to these family outings, but somehow, my presence is often felt.

We finish the conversation with her rushing me to talk about my school, basically all but saying, “Look, you deal with the school stuff and stay in your lane.” But when I begin to share my school experiences and tasks, it is not long before she’s usurping the discussion to dream about finishing her own scholarly work. She is now talking about doing things that sound eerily similar to what I’ve told her I am planning to do with my dissertation. I cannot seem to win in the validation department. And my frustration is growing and growing.

So for the past few mornings I’ve awakened with the thoughts, What am I doing here? How did I get back here? I feel like I am almost forcing my help on NMom, who I sense really doesn’t want me to swoop in and help her save her business. She is instead directing her energies into her scholarly work taking online short courses and figuring out how she can write and conduct research. She also seems to be neglecting her financial obligations while catering to a co-dependent [NSis], who is admittedly stealing her ATM card, forging checks, and receiving a paycheck from NMom’s business. Meanwhile, I am getting behind on my comprehensive exams and finishing three manuscripts and a grant proposal that will help fund my dissertation research.

A few weeks, later she calls me in a completely different mood…

Her: “I am thinking of hiring another nurse to help me with the visits. The old nurse we were using before just got a new job, so she is no longer able to do any more visits for me. And I’m getting behind.”

Me: “The last few times I called, you didn’t seem to have very much for me to do along that line.”

Her: “Well, there’s so much to be done, actually… I don’t know where to start.”

Me: “It would be nice if you could retire and just do the things you like to do.”

Her: “How is that possible?! I have to work for everyone else! I wish I could get it so that I didn’t have work so hard either.”

Me: “According to developmental psychology, at this stage in your life in your 60s you are thinking heavily about retirement and bringing your career as you once knew it to a conclusion and are finding new ways to bring meaning to your and your family’s lives and share the life lessons that you’ve learned with the forthcoming generations.”

Her: “Yeah, but how do I do that?! When your brother, Dad, sister and her children are so dependent on me to live. For example, I just got off the phone with your sister who wants me to let [Niece] come over here to my house everyday for the rest of the summer, so that she can avoid failing the 7th grade. Not enough kids signed up for summer school so an Internet-based summer school program was the only option. And she does not have a computer nor a phone line. But [Niece] complained and gave me attitude when I was reprimanding her for almost flunking and it pissed me off! If you don’t know how to listen and be quiet when I rant, I feel sorry for you. She couldn’t just sit there and listen! And everybody knows that I will try to do anything for you but you have to sit there and listen. So I just got real and I said, that’s it! She’s going to have to figure this out herself. And your bother, (YB), I heard he had been asking your sister if he could drive her car to go to [a town two hours away] to visit the old girlfriend with 11 kids. I told him I would take the car from [NSis] if I heard he was driving it. And he did. He went to [two hour town] and they all covered for him. [Niece] and a cousin were looking after Aunt E while [NSis] allowed him to use her car to drive to [two hour town].”

Me: “Isn’t he stable with his seizures?”

Her: (irate) “it’s not all about whether he’s had a seizure and is able to drive for 6 months or not, but about being stable within his own life?”

Me: “What do you mean?”

Her: (silent, then, in a more irate tone) “I mean, he’s in no position to be driving down trying to see those people. He’s not compliant with his treatment plan. He’s not stable. And I do not want him going to [two hours town]! Last year we had to go and get him from down there. He stole away and went down and nobody knew where he was. And he came home and fell out with a bad seizure. It’s just one thing after the other. We discussed this. And they did it again. The big question is “who told me?” But if everybody can remember…The Lord lets me know things in a flash. He brings it to me. Nobody has to tell me!”

Me: “Why didn’t he just take the bus?”

Her: “I’m tired of thinking for them. And putting up with every reason they give me. I’m just tired. He does whatever feels these days and I put up with it all year long. And because of my mercy… I’m trying to get your sister to understand how you have to get [Niece] to be a big girl and to help you.”

Me: “Why is [Niece] slipping in her grades so badly? She used to get such good grades. She’s a bright girl.”

Her: “I think I should let her suffer the consequences. And deal with the consequences throughout high school.”

Her: “I think he wants me to visit someone today, but I’m just having a hard time. I think I’m gaining weight in my legs and stomach area.”

Me: (realizing she’s saying her illness is keeping her from being able to make her visits, and thinking of the implications thereof, try another line of questioning) “What happened with [Nsis’s] situation last week? Didn’t you schedule an appointment for her with a mental health professional?”

Her: “Yes and she just didn’t go.”

Me: “That’s it? You seemed so upset last week with the dream and your need to get help for her.”

Her: (bitterly) “And I overheard [YB] talking on the speaker phone justifying why he left to go out of town to see that girl! I heard him tell someone: ‘Mom had no business leaving Aunt E in the house alone with me at night because I have these seizures and am therefore not a reliable or eligible caregiver for her.’ I told him: ‘You may just remember that once you were having a seizure alone with Aunt E in the house and it was she who went to the door and called for help when you needed it! And besides, who is he to stand up to me saying I shouldn’t be leaving him alone with Aunt E! I tell you everybody is just being disrespectful to me!”

Me: “Why would he say that?”

Her: “He was trying to justify going out all night long with those people. It’s like you said. If he wants go down with that girl for the rest of his life he can take a bus and get him a cab from the bus. For Aunt E, the alternative is the nursing home, but I’m not going to do that just for [YB’s] benefit. I’m just ready to give up. I don’t know. It’s just going deeper and deeper and deeper. And the IRS man is calling, blah, blah, blah…”

Me: “About what?”

Her: “About the $4000 that was behind? I’m not finished with that yet. They are trying to say they need some more money. That wasn’t the right amount. His call is never good. Tiffany, I haven’t been telling you everything that’s going on with the finances.”

Me: “Well, what are your priorities?”

Her: “I need to get rid of Aunt E to a nursing home and try to struggle out there and see her on a regular basis. And then [NSis] and [YB] will have to take care of themselves. [NSis] will not have a way to eat… [YB] will not have money for his seizure medicine… they really don’t realize how much Aunt E provides for them.”

Me: “I’m worried about the business and the monthly nursing visits. You were saying you were behind.”

Her: “I’m worried too! Other than that, I’m trying to work on this new policy and procedure manual that is being required of me by the state Medicaid department. They are really cracking down. The real deadline is a month from now. So I need to finish it or I will lose my contracts entirely and Medicaid is no longer accepting new contracts.”

Me: “So that sounds like a priority.”

Her: “Yeah. Like without that, none of this matters. And I haven’t filed last year’s taxes and they are due next month and it’s a struggle just trying to meet payroll.[OB] has been billing claims that we don’t quite have the paperwork to cover trying to make ends meet. And my conscious is whipping me about it. And I do care as a nurse, but I just don’t have the strength! And I’m sick all the time. And [OB], he’s showing signs of frustration especially with your sister, who is borrowing from me every 5 minutes. I’m going to see to it that Aunt E goes into the nursing home for 30 days and let ‘em survive however they can and let ‘em see how it’s a blessing to have her around. Then, I’ve got to make a decision about your father. He’s supposed to be helping me but because he’s always tending to your sister’s problems, he can’t help me to get out of the house and things like that. He doesn’t bring me ice water and I have dry mouth all night long. When he finally comes home, he tiptoes upstairs to his room with his smelly old books. I struggle to prepare for bed and I lay up all night. And he leaves early in morning and he has these potted plants and flowers he likes to water. He gets on me about not eating healthily but he’s always bringing in food that I’m not supposed to eat. And I throw it away. It just doesn’t work for me. So I’m not pleased with him being around. And because I’m sick, I can’t put up with it. And life is just so miserable. I’m so sick and tired of people talking to me any kind of way, just total disrespect! And I’m not going to deal with that child [Niece] being a smart-mouth and talking to me any kind of way. It’s not my job to raise her. And all time, she won’t study. She failed most of her classes. But her and her mother (NSis) didn’t tell me that. They said she was doing okay in her classes. The teachers gave her what she deserved! When [NSis] calls me, she cries and yells about how she needs help and you can’t get a word in edgewise. And I’m sick of it, literally. No joke. And with all these bills I have to pay… Tiffany, recently they applied garnishments to my bank accounts. This was a few months ago. They went to my payroll accounts and they also wiped out my personal and savings accounts. They didn’t get anything from payroll because it is not in my name, it’s in the business’ name.”

Me: “Who did that?”

Her: “The IRS… I’m not telling you everything, huh? I guess I’m telling you pieces. Right now the IRS man just calls anytime he feels, every time I look up. I was supposed to send $1500 then $1100. Then he called talking to me like I had done something wrong and had broken my promise to pay. But I reminded him that he must have forgotten what he told me earlier. He ended up saying, “It must have been a misunderstanding.” So he owned up to it. But I cannot just up and get another personal account because my name is mud. They check your credit. And Medicaid has been steadily decreasing the number of billable hours you can get as well as the hourly rate, so less money and more bills! I’m encouraging your brother [OB] to hang in there and am letting him get some profit from the business to make his ends meet. He’s the only one hustling in that place which is falling down to pieces. I told him, if you want it, and can make something out of it, you can have it. That’s how he’s surviving. [YB] is crying about how he wants his car fixed but I told him not to try to drive your sister’s car or I would take it from her. I told him not to go. He’s just sitting around whining.

Your sister keeps getting early advances on her paychecks… every pay period. She doesn’t even come to work sometimes. She never has gas in her car to go anywhere. [Niece] is failing school. I have no idea how the twins with their severe dandruff are doing. When I fell a couple of months ago, I called [Nsis] because I was naked. I think I dialed you or her, I don’t remember… But anyway, she never answers her phone in the mornings no matter the emergency, so it doesn’t matter. Your father eats all the food I bring into the house that’s worth anything. He can’t contribute to the household. If I have something made and it’s not eaten in a day, then he eats it. He bought an old 1991 custom van that had been sitting up for 4 years. It took 2 days for him to drag that van here. The back seat pulls out to a bed. I don’t know what kind of shape it’s in. He’s running behind this thing saying to me, “You and I are going to go to travel to a church convention in this van.” Tiffany, you know I’m not going to ride anywhere with him! Like that, in a ’91! He said he got a good deal for it paying $1000 for a vehicle they wanted $2400 for. I told him I already have a van that’s a 2007 and I already have the wheelchair ramp on it. Yes, it’s broken, but once I get it fixed, it would allow me to use my wheelchair and to go out sometime.

Tiffany, this is why I don’t tell you what I’m worried about. I tell you enough. Just don’t get… umm… discouraged. You see, I have always been there for my kids… when they were behind bars and everything. Like I told your brother [YB] not to take your sister’s car. I told him to make arrangements to get himself a car now that he can drive again. I told him, if I work hard, I can make the sacrifice to get him a vehicle. I will see if I can help you move around. They just take me for granted. And they won’t even hear anything I have say. It’s disrespectful. Believe me when I say when I shut down, I shut down. It’s upsetting, Tiffany, this stuff. Physically I’m not feeling that well.”

An endured silence lingers like a dark mist for 3 very long minutes. I did not make one sound. Only the banging sounds of my little one playing and the shrill laughter of Elmo from an episode of Sesame Street playing on my small bedroom TV could be heard over the speaker of my cordless phone. A cheeky song about family blasts loudly on the TV. “Family is up in a tree! And in the sea!” After the three minute silence, Nmom mumbles almost inaudibly.

NMom then re-enters her diatribe re-recalling Dad’s recently acquired conversation van. I told him, ‘Why don’t you get me a nice wheelchair if you want to take me somewhere out of the home. Nah, he can’t do that! That van! It’s not something I want! He keeps saying, “Look, we can travel to church conventions! But he really wanted that van for himself! It’s his dream! And when I beg him to take me to make one client visit, he always tells me he has to go somewhere and he walks around watering flowers. But suddenly when I want to do something, he’s gone. He’s not helping with one thin dime! There was a terrible thunderstorm yesterday and he got out and ran to check on your sister or something and left me in here by myself. He didn’t even check on me before he left, he just bolted out of here as soon as the storm started. Who get’s up and runs out at the beginning of a storm?! He must have started on his way and somehow realized he wasn’t going to be able to make it anywhere and he turned around and came back home. When he got back he said, (she imitates him using a saccharine, patronizing tone) “I got up the street a ways and realized I couldn’t leave you here in this storm.” But, Tiffany, what really happened was that a tree fell in the road and he couldn’t pass it. So he came back for his own self! Not for me. I’m sick of people using me, all the time. It’s hindering me. And you know what?!! (stopping abruptly). I’m trying not to talk badly about your father to you. I said I wasn’t going to do that anymore. (disconnecting, again) Everything is alright, is what I always say to myself. (she is talking more to herself than me at this point in the conversation) I’ve been trying to be positive. And to be different than before and to be nice. I’ve been trying for a while now! And nobody would even believe what I put up with… If they keep on treating me like this… I think more and more about it and… Whatever happens to everybody just happens!Then I have your brother [YB] telling me that I’m so wrong because I make Aunt E stay with him! He doesn’t hear me! I asked him, “What care do you take of Aunt Edith” He says: “Well you have to watch her, she’s always trying to get out. I say, What about the adult latches? He says: She figures them out….(silence again) All right, I guess… So whatever… But whenever they get ready to, they can foreclose on all of the leased properties occupied by [NSis], [YB], and [OB] at once if they want to. Because they are all consolidated on one property tax bill, now. The properties are run down terribly. But no one has any energy. The outside of [NSis’s] house is peeling and needs painting. Dad’s constantly putting his junk on the properties. He is still going to it with junk after junk after junk even sneaking some junk upstairs in my house. I’m starting to have house-itosis (a family word N-mom created that combines the meanings of the words house and halitosis, which means bad breath so in essence, bad house smell). ‘There is no sense in having you live over here!’I tell him. He wanted us to be ‘mums the word’ about our living arrangement so the church doesn’t get wind of the fact that we are not re-married but are living in the same house. But, I invited one of the church ladies to go with us to dinner after church one Sunday and I can tell from talking ith her that the people at the church already know. I’ve been praying asking God. Things that are going on that are wrong with me. Every time it’s time to go to church, I get sick. I get up in the morning and I’m sick all day. I say, Lord, what are you trying to say to me? I woke up a couple of mornings with a message, you have to be careful what you say. That people can speak curses on you. And people can speak curses by talking negatively about you. I’ve been trying, myself to cut back on being negative. Your Dad just speaks it all the time. I try to cut back, but with so many people speaking negative, it’s just a struggle trying to get over that negative talk. I try to get out of it, but I just fall back into it.”

“When I think of Aunt E and consider sending her back to the nursing home, I look at how they are doing this stuff to her and I wonder what are they going to do to me? They don’t even call to check on me. Your Dad sneaks in and out of the house and doesn’t always hear me when I call upstairs for him. [OB] is frustrated with me. Your sister ignores my phone calls. And your younger brother can’t help look after my only surviving family? I’m looking for an angel. I know I’m not perfect. But I sacrifice so much. And no matter what, I want you to finish school. I know whatever you do, it will go well for you… That’s why I’ve sacrificed so much to help you. And I would hope that you would remember that. And when the time comes, I won’t have a problem with living in a nursing home. My conscious is clear. I took care of my aunt and my mother in her last days and my conscious is clear.”

Me: “Have you thought about the possibility that everyone will turn out OK?”

Her: “Well, I know you’ll be OK and [OB] will be OK and Dad will be OK. But I’m really not sure if [NSis] and [YB] would be OK.”

Me: “Have they not told you, themselves that if something happened to you, they would be OK? [YB] said he would get SSI/disability to live in a group home or assistant living environment. [NSis] would start out on government assistance, but will eventually would be able to get a job since she does has her Bachelor’s degree. [OB] would land on his feet, as well.”

Her: after a dramatic silence “Well, maybe I forgot… Maybe it slipped my mind that they told me what they are going to do without me and my help? (Deep melancholic tone overcomes) Umm. Maybe…

At that moment (my baby let’s out a loud, happy shriek characteristic of pre-verbal one year olds. For the first time in the hour-long conversation, Nmom seems to notice her grand-daughter and says): “Is that [the baby’s name]? Well, Tiffany, maybe that’s something I needed to hear. That everyone already said they would be alright if anything happened to me. (long silence) Maybe that’s what I’m going to think about… (slowly) Yeah, you’re right, mumble, mumble. Yeah, I guess your right… (disappointment then silence) You know that can keep me going. That’s a good start. I can do what I need to do. I can’t do anything about it. Well, something’s gotta be done.”

Later that month in a conversation with [OB]:

[OB]: “I really need your help to do the nursing visits. They haven’t been done in 2 months and I am really starting to worry.”

Me: “In 2 weeks the business is in jeopardy of closing, right? Especially if that compliance paperwork isn’t completed, I thought.”

Him: “No, we are compliant. We just have to file a “Ready for site visit” form by Oct. 1. Mom has a lot of fear, anxiety, and control issues, and she will only let me go but so far in the administration of the company. I try to advise, but she does what she wants to do. So we are limited. There’s also some paranoia on her end. I know exactly how the money comes in. But I don’t know always know how it goes out all the time. Our sister has a lot to do with that, but I have no control over how she gives resources to her.”

Me: still wondering why she never mentioned Oct. 1 as the deadline.” Why would she tell me Aug. 1?”

Him: “Maybe she was trying to shock you into realizing how bad the situation really is. She needs your compassion and your empathy, right now. And the nursing visits would be the best way you could help.”

Me: “Why would she tell me she didn’t need me last week when I offered to come, then?”

Him: “I don’t know. But I do know what she needs now. She really needs for us to look out for her mental health as well as her physical health.”

Me: “OK, I’ll be in town later this week to help out…”

That night I toss and turn, not quite sure of what I’m worried about. Something, a tiny little voice deep inside, shouts at me, “Watch out!” The next day I call to NMom’s home to arrange a time to do the visits. Nsister answers cheerfully, but her cheerfulness quickly turns solemn as she, without greeting, hands the phone to my mother, whose initial cheerful mood also quickly changes as she begins to bark verbal orders at what seems to be many people in her bedroom. At a point, she yells, “Find the stuff, somewhere! Look over there, look in my purse, I’m on the phone with Tiffany, right now!”

To me she says: “So yeah, Tiffany, how’s school?”

Me: “Well, I have a big paper due Friday, but I should…” (I was going to say, be there Saturday to do the client visits).

She cuts me off mid-sentence, to yell at someone, “Just hand me my clothes!” She directs towards me: “Your sister is here helping me get my stuff together for the last consult for the bariatric (gastric bypass) surgery.

Me: “Have you had a chance to…” (I was going to say, work on your stuff for the state Medicaid)

Her: again, cutting me off, to yell at the others, “Move!”

Needless to say, we don’t get around to talking about or scheduling the nursing visits that brother so desperately wants me to make. A week later I find out that the bariatric surgeon said no way to the gastric bypass, that he might consider the lap-band, but he first wanted her pulmonary function to be re-assessed to assure she could withstand the anesthesia.

[NMom]: “So, I’ve decided I don’t want either surgery! I’m going to go on a liquid diet and live or keep things the same and die! But I will do the pulmonary function test, just to see what the status of my lungs are and what I can do to make that better.Like you said earlier Tiffany, state Medicaid is really cracking down on agencies, now limiting our weekly hours and requesting more information about caregivers’ income and employment verification and schedules. “I should really consider giving up the business, like you said”

She goes on detailing how she should just consider giving up the business, and focusing on the less-stringent consumer-directed contract and ‘like I said’ run the occasional class to keep the clients staffed and have the coordinator, [OB] do the monthly visits. With all the “like I saids” I was feeling a little suspicious, hearing the little internal voice crying out for me to, “Wait!” Why am I right all of the sudden? No one has ever listened when I portended the changes in the industry that warranted her consideration of her voluntary closing its doors.

But by the next day when she calls me as I am commuting to school for a meeting with my dissertation chair/advisor:

[NMom]: “I feel much better today. I was down yesterday, but I’ve been thinking about it and we can really make this business run. I am going to get serious about this diet, or I’m going to die, just face the facts! But I feel better today! Your brother and I are putting together a form that will make your home visits run smoothly, all the information you need is listed out clearly with directions to the patients’ home.”

Me: At this point, I am completely frustrated with the wishy-washy-ness and I express my real concerns about putting my license at risk by being joined with hers and the potentially fraudulent practices. I say, I want to be clear before I begin meeting clients without her that I am representing myself appropriately in terms of the proper contract status (for example having the proper insurance and bonding required of an independent nurse contractor). I have reservations about being rushed into doing the visits alone without a proper orientation and with clients who if asked later on audit who their nurse was, would most certainly raise a red flag implicating me, the daughter of the owner, whose paperwork is severely lacking.

She fumbled around the subject of my unfounded fears while I sat silently listening. She stumbled from one subject to another dismantling and contradicting the previous statement with the next. Finally, she says, “So you are worried that this could mess up your license, then?”

I once ran one of [NMom’s] offices for 6 years under my name and, with [NMom’s] help, or lack thereof, had it go down in a ball of flames, I’m worried that my name will be the one that goes if some type of investigation of the office takes place while I am on record as the RN. Likely, I would be the fall guy, as I was back in 2006, as was my sister at one time, as is my oldest brother, right now. It’s as if we adult children are there to be the fall guys for her ventures gone wrong.

She then rambles on about how just about anyone could come in a “whip the business back in shape” and it would make enough money to take care of itself.

[NMom]: “I know I told you that things seemed bad, but I feel better today. I think if I did what I needed to do, we could make this business work. Especially if I cracked down on the way the money goes out.”

Me: “Mom, I’ve got a meeting in a few minutes and I need a moment to get my head together for it.”

Her: “Okay well I just want you to know that there is still some value to the business” and she goes on for another 9 minutes.

I tune her out to focus in on a folder full of documents to be presented in my meeting. It doesn’t occur to me at the time to just say, Mom, WTF! I’ve got to go to a meeting! We’ve talked during the entire one hour commute. Just give me two minutes to think before I go into this important meeting!” But I don’t say anything. I just tune her out and pull things together.

In this moment, it becomes clear to me what I need to do. I decide this is a good time to implement a period of very low/no contact. Let them figure out what to do with the business and her health. At a point after the Memorial Day fall, I tried to make myself available to her to help as she was recuperating. I actually felt bad for her and ashamed of myself for being so aloof in the past. But here I find myself again, sucked into the Nmom-vortex, not quite sure how I got here, but most certainly ready to be free again. Maybe she will leave me be. Maybe she will sense my desire to withdraw and dig her claws in deeper. Whatever the case, I decide if I am going to get through the next set of academic tasks (completing my comprehensive exams, re-submitting a grant proposal to the National Institute of Health, and working on manuscripts for publication) I may need the help of a mental health professional to help me break this dizzying cycle, grasp hold to my sanity, and stop this roller coaster of drama and distraction.

In a conversation while standing in the parking lot of a nursing home several years back and more recently, when she was first considering putting Aunt E into a nursing home, my mother looked me square in the eyes and said, “If something ever happens to me and I have too many medical needs, you guys do not hesitate to put me in a nursing home and let the professionals take care of me. Just come and see me every once and while and check in on me...

A year of no contact with Nmom has passed… During this period, I completed my comprehensive exams and am in the ABD (all but dissertation) phase of my PhD program. And I write… papers and proposals and the dissertation… in iterations. I am enjoying my two daughters, 11 and 1, and my husband/friend of 14 years. With hubby as stay-at-home Dad and myself only teaching part-time, we are poor but we are happy. And hopefully, we will not be poor for long. At a point during this year of low contact (quarterly telephone check-ins) with my NMom, I hear through various grapevines, (i.e., Younger Brother-[YB], Younger Sister-[NSis], Older Brother [OB], and Dad), that everyone is at a heightened level of stress, on standby status while (currently hospitalized) NMom is experiencing acute bouts of anxiety, refusing to leave the hospital until she gets firm answers regarding her health condition. Fearing her impending death, her anxiety won’t let her resolve to go home; she (a nurse, herself of 30 years) proffers various scenarios for her current symptoms including a possible malignancy in her abdomen, liver problems, perhaps a kidney infection. However, anticipating her discharge from hospital, subsequently rehab, and potentially the nursing home for 24 hour care, the siblings and Dad hold a family meeting about how best to manage her day-to-day care. And for the first time in a year, I feel a tension, a pressure, a force tugging on me, pulling me into her field of gravity. The gravitas of the NMother dying… …and the oldest, daughter (also a nurse) nowhere to be found. For me, questions surround this phenomenon from both outside and within. I cannot confirm this, but I believe that when physicians, nurses, nurse’s aides, family members and visitors from the church ask her about me, Nmom, implies that my life is consumed by my family and my schooling and that it is difficult for me to find time to visit/care for her. To my siblings, it seems as if she puts me on a pedestal, idealizing the pursuit of the doctorate degree (one of which she also has), and being married and in a traditional nuclear family setup. Each of the siblings have personal struggles with their children’s other parent AND/OR their respective significant others. I believe this is largely NMom’s doing as she has never accepted a potential spouse into her fold. My husband knows with whom he is dealing and loves me despite my NMom and how she treats him, though it has not been easy. My siblings, particularly, my Nsister, has some resentment for the way NMom places me on a pedestal, particularly now that I am aspiring to the higher degree. She has no idea, though, that Mom never brags about me to me; that if it weren’t for my siblings resenting me, I wouldn’t know that my mom even thought anything of what I was doing. I cannot get too caught up in what others may be thinking of me. That drives me crazy with guilt and shame. I do think about what I am thinking of me. Internally, I am imagining the conditions surrounding NMom’s death and I am struggling. In my fantasy of her death scenario I wonder... Will I be attentive? Will I want answers? Will I understand that I probably won’t get them? Will she expect round-the-clock care from me? Will she let up on me? Will the family hate me if I fall short of NMom’s expectations? As these thoughts invade, my anxieties step into overdrive, my belly flip-flops and I note the increase in my irritability. Welcome back to NMom’s stratosphere…

My first instinct is to call the therapist that helped me think through things a year earlier, when I was at my wit’s end. Six sessions of thinking through my priorities and life goals. Six sessions during which I see an improvement in most, if not all of my anxiety/panic symptoms. But somehow, before I can sign up for another six sessions, I get a call from [Hometown] and NMom’s gravity pulls me in closer...

“Why won’t they explore those 6,000 cc of fluid I passed when they catheterized me?!” NMom is upset because though she took no diuretic, she mysteriously passed 6 L of urine when she was in the E.R. after a bout of abdominal discomfort.

“I had a young nurse in here yesterday and [Older Brother] was telling him that I was a Nurse Practitioner and she was telling him that that is what she wanted to go to eventually go back to school for, so I gave her an assignment to go look up the word “ascites” on her computer when she got home from work and let me know what she found when she came back in today. She printed out the symptoms and I gave this printout along with a list of my other symptoms to Dr. Majeeb this morning. So he’s getting a scan of my stomach later today. The Dr. didn’t read the info she gave me but I had [her ex-husband, my Dad] sit down and write a letter for me. And I didn’t show it to anybody else and he’s acting upon that. And I’m going to be discharged this evening after the scan.”

Me: “They are going to discharge you?”

NMom: “That’s the plan. I’ll come back to see Dr. Majeeb in a week. But I am still a little weak. [Younger Brother] just called to check on me and [Older Brother] is going down to get us something to eat. Your daddy is over there in the chair sleeping. I was just here reading the information the nurse gave me and I was reading all of the symptoms of ascites. I think that fluid is ascites. ‘They’ were talking about maybe it’s liver damage from all the medicines I’ve been taking. Could be damage to my kidney. And my blood sugar won’t go down, the lowest is 290. I drink a little bit. He just gave me a forkful of eggs and a piece of beef sausage patty and I’m full. And Dave has been eating the food from my tray for me…”

Me: “Aren’t they keeping up with what you eat?”

NMom: “They should be…This young nurse is real concerned and she is working on my behalf. The doctor ordered two more tests before I’m discharged. This is good, right. I’m going to read about all the symptoms I had.

-Weight gain of 24-32 kilos in four days-Pain in sternum on left side and/or back at night-Swelling of legs, abdomen-Wheezing -Increased shortness breath-Irregular heartbeat with pounding-Urinated 7 Liters of clear, whitish fluid The nurses are focused on my blood pressure. When I urinated, my blood pressure lowered and my stomach got softer without any emergency treatment. I am sending the doctor information for consideration and further testing before leaving today. And I sent him online information on ascites. He didn’t look at that information too much but he knew… and he paid attention to my letter. And he said, it may be my heart…So that’s where I am now.”

Me: “Have you seen your nurse?”

“She came in this morning. She was thinking it might be liver damage with all this medicine. So the test will be a scan looking for fluid in the abdomen and checking my heart to see if it’s weak and something’s going on.That’ll be good enough for me.”

[OB] comes in the hospital room to tell our Dad, “You should go down to the cafeteria. They have grits. Go ahead and eat Dad, you need to keep your strength up. You’re almost 68!”

Mom interjects: “I’m so weak and wobbly.” To me, “You know I was in isolation don’t you? Go ahead downstairs and eat Dave! [OB] wanted to know if you knew. The tests came back and they took me out of isolation. [NSis] came down here to give me a bath yesterday. So many people were here, she didn’t give it to me but I managed.”

[OB] mumbles something I cannot hear, but NMom does. She chuckles. “[OB] you didn’t have to say that. Then to me she says, “I feel weak , but I feel better. This morning I had a 1000 cc’s out and I don’t feel my bladder, it can’t tell me I’m full.”

[OB]: “It can’t?”

Mom: “No, it can’t.”

[OB]: “Mom, I got to go to work…”

Mom to me: “Well, how are you doing?”

[OB]: “Mom, I got to go to work…”

Mom: “Huh, well we need to pay the quarterly taxes. I’ll pay that when I get home (from the hospital). Will the girl be there when I get home? To [OB]: How much money do you owe her? I thought you paid her Friday and gave her $10 extra. Well then that’s a red flag isn’t it. Don’t call her back. She’s desperate. She came on to [OB]. You gave her money $100 on F. So she’s already in your pocket! So call her up and tell her we’ll call her. And find me somebody. I’m not going to lay in that house, even over the weekend without having a female. I want Pioneer and I want her to get paid like a nurse’s aide. Okay, [Tiff],. I don’t need to hold you up…”

Me: “So what’s your next move?”

Mom: “I’m going to go home and regroup and take a sabbatical and get somebody who can help me get on my feet and get to these doctor’s appointments and stay at home and decide what I want to eat and don’t worry about going out to do this and going out to do that. When I was sick I was confused and couldn’t focus. This oxygen, cirrhosis, pancreatic ascites, they can’t deal…”

[OB] speaks up suddenly talking about work issues. You’ve got a call from [receptionist] saying that someone can’t go to work or something.

Mom: I just want to go home and get in the bed, (more weakly than before)

[OB]: So, don’t worry about that, alright?

Mom: Yeah, so I had that fluid so I couldn’t urinate right, I just couldn’t get that fluid off me. The liver may be… weight gain, swollen ankles. Umm-hmm yep, I had all those symptoms. A couple of times I got cramps in my leg. And I asked about the potassium and they gave it to me for the first time yesterday.

Me: “Well the blood tests they ordered will tell you what you want to know about the fluid balance. When do they say the tests will be back?

Mom: The nurse says I won’t be discharged until the tests are done. So discharge is on hold right now. I’m OK

I begin to tell her that I will check on her later when she offers: “Oh, I knew you were busy. Wow! Wow! Wow! I’m just hoping and praying for you. Don’t feel obligated to be here with me… This is very important to me. For you and family to move on and reach your dream. I’m so proud that you stuck with something in spite of…I tell you you’ve got a dream. You’ve just got to go for it one piece at a time. You’ve just got to work for it. It was a good feeling when I got my degree in both places but in the back of my mind I always wanted my Bachelors and my Doctorate degrees in nursing. It seemed impossible. For a lot of people that seemed smarter than you were, it comes easy to them. But there is something wrong with their brain. It takes a special kind of person to be an entrepreneur. There’s something special about them. People say how did YOU make this business work? And the entrepreneur says, I don’t know! I just work hard . It’s something special, they just strive and push their way.

When I got my doctorate, professionals came to eat dinner with us and they asked if we had questions and I asked how do you deal with people who haven’t sacrificed like you have (to earn a doctorate a ministry)? And he said when you both sit on the pulpit the way you carry yourself everyone is going to know it and you’ll be so proud of what you’ve been through so you won’t be cocky and it won’t be because of your strength but because of what God took you through. I don’t have much to give you, but I can encourage you with these words. But the Lord is going to let you have it earlier (in life) because you know m-more. You’re supposed to let ‘em fly. Let ‘em go. Let ‘em do everything that they think they can do. And that’s what you are doing? I don’t care if things aren’t going right. I don’t want you to stop pursuing your degree. We can communicate and pray and let God take us through. Even Jeremiah… When you feeling like you can’t share no more and you don’t know what to do but you… I know you’ve got this nervous condition. This type A personality. You get things to go your way. You’ve got that stomach condition and it works on your nerves. But I pray that you hold on. And you will. And you will. (The words seem encouraging; however, I cannot help but hear disappointment in her voice). I keep thinking about that computer I want to get you. I just… kinda… It’s moments like this. I think I should do something special for you.

Me: No, you don’t have to do anything for me. If anything I owe you for helping me out with some money to pay a bill recently. I appreciate what you have done for me and my family

Her: No, you are spiritual enough to know that it is the ENEMY [Satan], not the person that is trying to get you. And you know that God wants you to forgive and for you to keep on going and to trust and rely on God and realize it’s not the person, but the ENEMY that’s against you.

I had that brain. And God let me know that that was a camouflage and God showed me that that was a healing. And she goes on about her miracle healing taking place in the lungs. And then she began to reconcile how the doctor looked at the lungs but decided that he needed to order to tests for my heart and abdomen. SO I believe it’s in God’s plan. It’s kinda hard getting around to what you need. But he’s supplying your needs SO we are supposed to keep going around. The Lord loves you and he’s with you. Your Holy Ghost is still there. And if you are not doing what you are looking to do, He has you going where He want’s you to be. Look who he took, Jesus, but at 33 he began to minister. He was an ordinary person moving around, nothing spectacular, just a good boy a good man, getting ready to mature. But all the time God was talking to him. Getting him ready. That’s what God is doing for you. He’s getting you ready. You still gotta go through your problems. And the way you handle it puts a smile on his face. Your acting like your heart is. You have a good heart. The more you do that. The more he will fight your battle. You’re a good girl. You’ve always had a good heart. You have a tender heart too. You’ve gotta protect yourself. If I could help…

Me: I appreciate the words. I’m trying to keep it together

Mom: It will be the happiest moment for me. For you to walk in and show me that degree. Don’t worry about me. You have a supportive family and I think he gave me more care, more attention with the rest of the family. And [Dad] has been sticking with me. And I’ve got you working hard over there and if you need money for tuition. Just make your way down here and I can always squeeze something out.

Two weeks later (August, , another hospitalization I don’t go to visit her because I am taking comps, and afterwards am sharing a vehicle with my husband, a vehicle that minutes before indicated to him a check engine light.

On this hospitalization, she has 4 CT scans. Then, I go back on no contact for four months. By December of that year (2011) I find myself having a family meeting with the entire family including all siblings and Dad:

Dad: She does not want the nursing home! She wants to stay in the house and have the family and caregivers provide 24-hour round-the-clock care. She speaks of being at odds with herself about wanting us to have our independence, her having hers, and feeling like a burden or a worry to us.

In the family business, she doesn’t want to deal with the day-to-day problems being brought to her and having to worry about her employees and childrens’ income issues.

When someone is with her in her house, which helps in her anxiety about being alone, she complains about the lack of quality time spent with the person. Perhaps they don’t engage with her enough. Or they spend too much time talking about their own lives. She is also feeling some pride about exposing herself to the men. And she cannot afford a home aide full time.

So from this dilemma, Plan B was hatched by [OB]: ‘The Aunt E Plan’ of long-term health care with some considerations: [OB] will arrive for early morning setup on most days. Let Aunt E’s Medicaid caregiver cover the daytime hours for the both of them and bring E’s retirement income into Mom’s house, splitting it between [NSis’s daughter], and the expenses for the house in which NSis lives.

[OB]: The house would need to be re-arranged. [The current housekeeper/cook]-needs to be let go. She has a problem coming in close contact with Mom’s bodily fluids or her medical equipment and supplies. And Mom only eats sandwiches, so she doesn’t need a cook…

We could get a personal care aide to do the catheter care and to change the dressings and to do the stuff that would burn out the family members.

I hear myself say: “I may be able to come four to six hours each week to provide some respite to her usual caregiver.” I hear myself say this despite my very low income, my car being on its last legs, and myself being in a final, intense push to graduate in May. I add: “I’ll check her vitals, do some catheter care, and other nursing stuff and stress/mental health support. Mom said something about paying her personal bills but I suppose [OB] would handle that.”

The elephant in the room is NSis considered a lost cause. [OB] thinks she should stay at where she is and let her figure out childcare when she has to go to take care of Mom. [NSis’s daughter] was also being incentivized to cover a few hours with Mom with a few dollars a week.

It is also decided (by NMom and [OB]) that [YB] move in with NMom to help monitor her and keep her company. [OB] will teach [YB] his daily process with Mom and the importance of spending the time with her and doing things that are needed quickly. But importantly, sitting with her for a little while will make the quality of the time with NMom better and should be done before running off to do other things.

I mention to [OB] to let our mother know that [YB] needs his "[YB]-time" and that sometimes he needs to get in the van and get out.